Original articleIncidence and Progression of Geographic Atrophy: Observations from a Population-based Cohort
Section snippets
Study Population
The BMES is a population-based cohort study of vision and eye disease in persons aged 49 years or older residing in the Blue Mountains region west of Sydney, Australia.18, 19 The baseline study recruited and examined 3654 participants (82.4% of those eligible) between 1992 and 1994 (BMES I). Of these, 2334 participants (75.8% of survivors) attended the 5-year follow-up examinations (1997–1999; BMES II). The 10-year (2002–2004; BMES III) and 15-year (2007–2009; BMES IV) follow-up examinations
Results
Of 3654 baseline participants, 2572 had been followed-up at least once since the baseline examination. Of these, 68 participants had late AMD at baseline or developed neovascular AMD by first follow-up after baseline (and were thus not at risk of developing GA), and 1 participant had ungradable photographs at all visits. This left 2503 participants included in the assessment of GA incidence. Table 1 presents baseline characteristics of the BMES participants with incident GA and without any late
Discussion
In this older Australian cohort, we found an overall 3.6% incidence of pure GA over 15 years. Common AMD risk factors, including increasing age, history of smoking, genetic risk from the CFH and ARMS2 alleles, and regular fish consumption, were associated with long-term incidence of pure GA. In addition, early AMD lesion characteristics strongly predicted risk of GA independent of the known risk factors discussed earlier. We also found that fast progression of GA was more likely to occur in
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Financial Disclosure(s): The author(s) have made the following disclosure(s): P.M. is a consultant for Novartis and Bayer. The other authors have no proprietary or commercial interest in any materials discussed in this article.
Supported by the National Health and Medical Research Council, Australia (Grants 974159, 211069, 457349). The National Health and Medical Research Council had no role in the design or conduct of this research.